No Effect of Platelet-Rich Plasma Injections as an Adjuvant to Autologous Cartilage Chips Implantation for the Treatment of Chondral Defects

Abstract

Background Repair of chondral injuries using cartilage chips has recently demonstrated clinical feasibility. Autologous platelet-rich plasma (PRP) is a potential promising technique for improving healing response during cartilage repair. Purpose To assess the cartilage repair tissue quality after autologous cartilage chips treatment (CC) with and without repeated local injections of PRP for the treatment of full-thickness focal chondral defects of the knee. Materials and Methods Two full-thickness chondral defects (Ø = 6 mm) were created in the medial and lateral trochlea facets of each knee in 6 skeletally mature Göttingen minipigs. The 2 treatment groups were (1) CC with 1 weekly PRP injection for 3 weeks ( n = 12) and (2) CC alone ( n = 12). The animals were euthanized after 6 months. Samples of whole blood and PRP were analyzed for concentrations of platelets and nucleated cells. The composition of the cartilage repair tissue was assessed using gross appearance assessment, histomorphometry, and semiquantitative scoring (ICRS II). Results Histological evaluation demonstrated no significant difference in the content of hyaline cartilage (CC + PRP: 18.7% vs. CC: 19.6%), fibrocartilage (CC + PRP: 48.1% vs. CC: 51.8%), or fibrous tissue (CC + PRP: 22.7% vs. CC: 21.8%) between the treatment groups. Macroscopic evaluation did not demonstrate any difference between groups. Conclusions PRP injections after CC in the treatment of full-thickness cartilage injuries demonstrated no beneficial effects in terms of macroscopic and histologic composition of cartilage repair tissue.

Mesenchymal Stem Cell Extracellular Vesicles as Adjuvant to Bone Marrow Stimulation in Chondral Defect Repair in a Minipig Model

“…The Göttingen minipig chondral defect model has previously been described by our group. 29,45-47 Briefly, after premedication with Zoletil mix 1 mL/10 kg (tiletamin 2.5 mg/mL, zolazepam 2.5 mg/mL, torbugesic 0.5 mg/mL, ketaminol 2.5 mg/mL, and rompun 2.5 mg/mL; Virbac, Denmark), general anesthesia and local analgesia were achieved with Etomidate (Hypnomidate, 0.25 mL/kg; Janssen Pharmaceuticals), sevoflurane (3%; AbbVie, Denmark), fentanyl (0.175 mL/kg/h; Hameln Pharmaceuticals), and lidocaine (Xylocaine 10 mL, 20 mg/mL; Astra Zeneca, Denmark). Preoperatively, prophylactic antibiotics were administered (penicillin procaine, 0.03 mL/kg; Ceva Sante Animale, France).…”

Autologous Minced Cartilage Implantation for Treatment of Chondral and Osteochondral Lesions in the Knee Joint: An Overview

“…However, there is contradictory evidence in PRP effect and cartilage repair, which is not the focus of this review. 48-50…”

Particulated Cartilage for Chondral and Osteochondral Repair: A Review

“…After 6 months repair, tissue showed features of mature hyaline cartilage both macroand microscopically. In 2019, Olesen et al 33 compared the use of autologous fragmented cartilage in chondral defects of mini pigs with and without the addition of platelet rich plasma. The authors found approximately 20% hyaline cartilage, 50% fibrocartilage, and 22% fibrous tissue in both groups, and concluded that the addition of platelet rich plasma had no beneficial effect on repair.…”